Serodiscordant Relationship

Couple sitting on deck looking outSerodiscordant relationship is one of several terms used to describe a relationship in which one partner is HIV positive and the other is not. The term serodiscordant—which comes from the words “seroconversion,” the medical term to indicate HIV positive status, and “discordant,” meaning “at odds”—is not preferred by all people. Some other terms used to describe this type of relationship are positive-negative, mixed status, mixed sero-status, and sero-divergent.

Challenges in a Serodiscordant Relationship

All relationships face challenges particular to the people involved; in a serodiscordant relationship, partners face a specific challenge in that one partner in the relationship is positive for HIV. In many cases, partners enter relationships knowing their HIV status, but sometimes people enter into a serodiscordant relationship unknowingly when the HIV status of one or both partners is not known. With regular HIV testing, people are more likely to be aware of their HIV status. Due to scientific advances in medicine and increased knowledge about HIV, many people who may not have entered into a serodiscordant relationship in the days when HIV was just emerging and fear of the virus prevailed, may now be willing to consider a mixed-status relationship.

Though a positive-negative relationship will face many of the same challenges that any relationship faces, some unique obstacles may be present. The HIV-positive partner may worry about infecting the other partner, or the HIV-negative partner may feel overly solicitous toward the positive partner, placing too much emphasis on caring for him or her and neglecting other aspects of a healthy relationship.

Additionally, because both HIV and the medications that treat HIV can have unpleasant effects on the body, the positive partner may feel unattractive or undesirable, in addition to coping with poor health. Partners may also become cautious or feel wary about engaging in specific sex acts, such as intercourse, and they may cease certain kinds of sexual activity altogether. Restrictions surrounding physical intimacy can affect a relationship negatively, as regular sexual intercourse is generally considered to be an essential part of a healthy intimate relationship.

Transmission Risk in a Serodiscordant Relationship

Although there is always some risk of transmission involved in sexual contact with an HIV-positive person, there are many ways to reduce that risk. Antiviral medications (ART) both control the infection and render it less likely to be passed on to an uninfected partner. Condoms, when used correctly, also significantly reduce the risk of HIV transmission.

Pre-exposure prophylaxis, or PrEP, is another way that HIV-negative partners can protect themselves. When taken correctly by the negative partner, this pill has been shown to reduce the risk of transmission by up to 90%. Some couples forgo the medication, however, choosing to continue to protect themselves with condoms rather than taking a medication they deem unnecessary. In heterosexual couples, this medication can be helpful if the couple wishes to conceive a child naturally. An HIV-positive partner on ART with an undetectable viral load is very unlikely to transmit HIV to a negative partner who is taking PrEP.

Partners can also participate in sexual activities that carry less risk, practice good communication, and educate themselves about the transmission of HIV and other sexually transmitted diseases, which is particularly important when partners may be sexually active outside the relationship, as in a polyamorous relationship. These steps may also prove beneficial to any healthy relationship.

Some couples find that therapy—both individual and couples counseling—can help them balance the stresses of a serodiscordant relationship.

References:

  1. Couples With Mixed HIV Status. (2014, February 24). Retrieved from http://aidsinfonet.org/fact_sheets/view/613
  2. Heitz, D. (2014, February 26). What’s My HIV Transmission Risk? FAQs for Mixed-Status Couples. Retrieved from http://www.healthline.com/health/hiv-aids/transmission-risks-faqs-serodiscordant-couples#Overview1
  3. Reynolds, D. (2014, October 8). As PrEP Becomes More Available, Couples With One Poz Partner Consider Treatment. Retrieved from http://www.advocate.com/31-days-prep/2014/10/08/prep-becomes-more-available-couples-one-poz-partner-consider-treatment
  4. Serodiscordant Relationships. (2004, March 1). Retrieved from http://www.thebody.com/content/art50150.html

Last Updated: 01-29-2016

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